Vitrectomy probe with adjustable cutter port size

• US 8,888,802 B2
• Filed: 12/21/2010
• Issued: 11/18/2014
• Est. Priority Date: 12/21/2010
• Status: Active Grant

• Current Assignee: Alcon Research, LLC (Alcon Incorporated)
• Original Assignee: Alcon Research Limited (Nestle SA)
• Inventors: Underwood, John R., Auld, Jack Robert, Huculak, John Christopher
• Primary Examiner(s): Severson, Ryan
• Assistant Examiner(s): Papeika, Rachel S
• Application Number:
  US12/974,722
• Publication Number:
  US 20120157906A1
• Time in Patent Office: 1,428 Days
• Field of Search: 606/107, 606/161, 606/166, 606169-171, 606/177, 606/178, 606/180, 604/22, 600562-570
• US Class Current: 606/171
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 2017/00402 Piezo electric actuators
• CPC Class Codes: A61B 2017/320028 with reciprocating movements
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61F 9/00763 with rotating or reciprocating cutting elements, e.g. concentric cutting needles atherectomy cutting instruments A61B17/3207; endoscopic cutting instruments A61B17/320016
• CPC Class Codes: Y10T 137/86839 Four port reversing valves
• CPC Class Codes: Y10T 137/87217 Motor
• CPC Class Codes: Y10T 137/87233 Biased exhaust valve

Abstract

Vitrectomy probes and system related thereto are disclosed herein. The disclosure describes various example vitrectomy probes having an adjustable cutting port size. Various example features are described for adjusting the size of the cutting port. Further, the disclosure provides examples for adjusting the size of the cutter port while the vitrectomy probe is in operation.

Claims

1. A vitrectomy probe comprising:

a housing;

a cutter extending longitudinally from a first end of the housing, the cutter comprising;

an outer cutting member coupled to the housing;

an inner cutting member slideable within the outer cutting member, the inner cutting member slideable between a retracted position and an extended position; and

an adjustable port, a size of the adjustable port defined by an edge of an opening formed in the outer cutting member and an end surface of the inner cutting member when the inner cutting member is in a fully retracted position;

an oscillator operable to reciprocate the inner cutting member;

a first chamber formed in the housing; and

a stroke limiter operable to limit the size of the adjustable port, the stroke limiter comprising;

a moveable element moveable relative to the inner cutting member, the moveable element moveable within the first chamber in response to a pneumatic pressure within a portion of the first chamber, the moveable element adapted to be positioned to engage the inner cutting member at a selected position defining the retracted position of the inner cutting member.

2. The vitrectomy probe of claim 1, wherein the moveable element is longitudinally moveable within the first chamber.

3. The vitrectomy probe of claim 1, wherein the stroke limiter further comprises:

a diaphragm disposed within and dividing the first chamber into a first chamber portion and a second chamber portion,

wherein the moveable element is moveable with the diaphragm to a defined position, the diaphragm moveable in response to pneumatic pressure in the second chamber portion, the pneumatic pressure alterable to a selected pressure to move the moveable element to the defined position, and

wherein the fully retracted position of the inner cutting member is a location of the inner cutting member when a portion of the inner cutting member contacts the moveable element at the defined position.

4. The vitrectomy probe of claim 3, wherein the stroke limiter further comprises a bias element disposed within the first chamber portion between the housing and the moveable element, the bias element adapted to apply a biasing force counter to the pneumatic pressure applied to the diaphragm.

5. The vitrectomy probe of claim 3, wherein the second chamber portion is in fluid communication with a passage, the passage adapted to transmit the pneumatic pressure to the second chamber portion.

6. The vitrectomy probe of claim 3, wherein the inner cutting member comprises:

a hollow cutting member;

a tubular member; and

a hollow coupling joining the hollow cutting member and the tubular member, and

wherein a surface of the hollow coupling forms the portion of inner cutting member that contacts the moveable element at the defined position.

7. The vitrectomy probe of claim 1 further comprising a second chamber formed in the housing, wherein the oscillator comprises a diaphragm disposed in the second chamber.

8. The vitrectomy probe of claim 7, wherein the inner cutting member comprises:

a hollow cutting member;

a tubular member;

a hollow coupling joining the hollow cutting member and the tubular member; and

a central passage formed by the hollow cutting member, the tubular member, and the hollow coupling, the central passage adapted to allow passage of aspirated materials during operation of the vitrectomy probe.

9. The vitrectomy probe of claim 7, wherein the diaphragm divides the second chamber into a first chamber portion and a second chamber portion,

wherein the diaphragm is adapted to move in a first direction in response to a pneumatic pressure in the first chamber portion, and

wherein the diaphragm is adapted to move in a second direction in response to pneumatic pressure in the second chamber portion.

10. The vitrectomy probe of claim 9, wherein movement of the diaphragm in the first direction moves the inner cutting member in a retracted direction, and wherein movement of the diaphragm in the second direction moves the inner cutting member in an extended direction.

11. A vitrectomy probe comprising:

a housing;

a cutter extending from a first end of the housing, the cutter comprising;

a hollow outer cutting member coupled to the housing, the outer cutting member comprising an open end and a closed end;

a hollow inner cutting member slideable within the outer cutting member, the inner cutting member comprising open opposing ends and a first cutting surface at a first end thereof; and

an opening formed in the outer cutting member proximate an end thereof, the opening having a second cutting surface cooperative with the first cutting member to dissect materials that enter the opening, the opening and the first cutting surface defining a port, a size of the port defined by a location of the first cutting surface relative to the opening when the inner cutting member is in a fully retracted position;

a first pneumatic chamber formed in the housing;

a first diaphragm coupled to the inner cutting member and dividing the first pneumatic chamber into a first chamber portion and a second chamber portion, the first chamber portion in fluid communication with a first passageway and the second chamber portion in fluid communication with a second passageway, the first passageway and the second passageway adapted to transmit a first pneumatic pressure to the first chamber portion and the second chamber portion, respectively, in an alternating sequence to oscillate the first diaphragm and the inner cutting member between the fully retracted position and a fully extended position;

a second pneumatic chamber formed in the housing;

a second diaphragm dividing the second pneumatic chamber into a third chamber portion and a fourth chamber portion;

a stroke limiter coupled to the second diaphragm and moveable therewith; and

a third passageway in communication with the fourth chamber portion, the third passageway adapted to transmit a second pneumatic pressure to the fourth chamber portion to displace the second diaphragm an amount proportional to the second pneumatic pressure.

12. The vitrectomy probe of claim 11, wherein the stroke limiter is moveable to a selected location by variation of the second pneumatic pressure.

13. The vitrectomy probe of claim 11, wherein the inner cutting member comprises:

a hollow cutting segment;

a tubular member; and

a hollow coupling disposed between and joining the hollow cutting segment and the tubular member to form an interior assembly, the interior assembly extending through an aperture formed in the first diaphragm and an aperture formed in the second diaphragm, and the interior assembly defining a continuous central passage adapted to pass aspirated materials during operation of the vitrectomy probe.

14. The vitrectomy probe of claim 13, wherein the stroke limiter comprises a first contact surface, wherein the hollow coupling comprises a second contact surface, and wherein contact of the first contact surface with the second contact surface defines the fully retracted position of the inner cutting member.

15. The vitrectomy probe of claim 14, wherein an alteration to the second pneumatic pressure alters a position of the stroke limiter to cause a change in the size of the port by altering the fully retracted position of the inner cutting member.

16. The vitrectomy probe of claim 11, wherein the housing comprises a longitudinally disposed interior sleeve, and wherein the stroke limiter is slideable on the interior sleeve.

17. The vitrectomy probe of claim 11 further comprising a biasing member disposed in the second pneumatic chamber between the housing and the stroke limiter, the biasing member adapted to apply a biasing force on the stroke limiter counter to the second pneumatic pressure.

18. The vitrectomy probe of claim 17, wherein the biasing member is a spring and wherein the biasing member is disposed in the third chamber portion.

19. A system comprising:

a vitrectomy probe comprising;

a housing;

a cutter extending from a first end of the housing, the cutter comprising;

a hollow outer cutting member coupled to the housing, the outer cutting member comprising an open end and a closed end;

a hollow inner cutting member slideable within the outer cutting member, the inner cutting member comprising open opposing ends and a first cutting surface at a first end thereof; and

an opening formed in the outer cutting member proximate an end thereof, the opening having a second cutting surface cooperative with the first cutting member to dissect materials that enter the opening, the opening and the first cutting surface defining a port, a size of the port defined by a location of the first cutting surface relative to the opening when the inner cutting member is in a fully retracted position;

a first pneumatic chamber formed in the housing;

a first diaphragm dividing the first pneumatic chamber into a first chamber portion and a second chamber portion;

a stroke limiter coupled to the first diaphragm and moveable therewith, the stroke limiter moveable relative to the hollow inner cutting member, the stroke limiter adapted to limit a retracted position of the inner cutting member, the limited retracted position of the inner cutting member defining the fully retracted position;

a first passageway in communication with the first chamber portion, the first passageway adapted to transmit a first pneumatic pressure to the second chamber portion to displace the first diaphragm an amount proportional to the first pneumatic pressure; and

an oscillator coupled to the inner cutting member and adapted to oscillate the cutter between the fully retracted position and the fully extended position;

a surgical console pneumatically coupled to the first passageway of the vitrectomy probe and adapted to alter the first pneumatic pressure supplied to the vitrectomy probe based on a user input; and

an input device coupled to the console, the input device adapted to receive the user input and cause the console to alter the first pneumatic pressure supplied to the vitrectomy probe thereby altering the size of the port of the cutter.

20. The system of claim 19, wherein the input device is a footswitch.